E-cigarettes and their restricted use in Coconino County and around the globe are tempered more by the unknown than what research and other fact-finding officially has proven. Former tobacco consumers praise vaping for helping them quit, even as lawmakers debate public health risks, medical/insurance impacts, safety claims and regulation of ingredients, advertising and sales.
The challenge dates to 2003, when a Chinese pharmacist patented a battery-operated and cigarette-simulating device to vaporize e-liquid, or juice, made from flavorings, propylene glycol, extra additives and nicotine levels touted to be 10 times lower.
Adult use of e-cigarettes in the United States doubled from three to six percent from 2010 to 2011, according to Denise Burley, division manager of the Coconino County Public Health Services District (CCPHSD). Some experts predict that e-cigarette sales could surpass those of tobacco cigarettes in 10 to 20 years, she adds, because of aggressive marketing, paying for counter space and tobacco companies entering the industry.
Burley said, “The chemicals used in electronic cigarettes have not been fully disclosed and there is no adequate data on their emissions. [The World Health Organization] concluded that consumers should not use these products until they are deemed safe and effective by a competent national regulatory body.”
Such regulation has been urged of the Federal Drug Administration (FDA), but no progress has been communicated. Meanwhile, lawmakers’ concerns about health effects, a potential resurgence in the popularity of smoking, curiosity among young people, air quality impairment and lack of regulatory oversight have spurred e-cigarette constraints.
Arizona’s indoor workplaces and public venues, including restaurants and bars, were mandated smoke-free from tobacco in May 2007. Statewide, selling e-cigarettes to anyone under 18 years of age has been illegal since 2013. E-cigarettes were added in 2011 to the Coconino County County Smoke Free Air Ordinance, prohibiting their use at indoor workplaces and public venues in unincorporated areas. The City of Flagstaff’s no smoking ordinance became effective in 2005, but does not include e-cigarettes. Within the city’s municipal buildings, however, both smoking and vaping are barred.
Burley named Flagstaff Medical Center, North Country HealthCare and Flagstaff Unified School District as entities that have issued “tobacco free buildings and grounds policies.” Another is Northern Arizona University, where the Student Health Advocacy Committee presented to administrators a proposal to make the entire campus smoke, vapor and nicotine free, expanding the current ban in university-owned buildings and vehicles.
“There is a proposal in front of our president and her close advisors,” confirmed Tom Bauer, director of public affairs for the NAU Flagstaff campus. “It will not be ‘cleanly’ enforced, in that we are an educational institution and want to educate about the dangers of tobacco…What we hope to do is take a long time to introduce help to people going through different means of cessation.”
Because a smoking ban also would affect employees and faculty, Bauer said the administration would research and “start polling people…It’s not something we would do on a whim,” citing health reasons, littering, unclean air and a national trend toward prohibiting smoking on campuses as motivations for a policy change.
The Arizona Department of Health Services (ADHS) reports that 1.14 million Arizonans (17 percent) use tobacco and about seven percent have used e-cigarettes. Among adults in Coconino County, Burley says, surveys show that 12.8 percent smoke cigarettes, 3.4 percent of them daily.
Mark Blancher, a two-pack-a-day smoker for 20 years, has not smoked since he began vaping eight months ago.
“I can run around the block a little quicker and I am not out of breath when I am done,” Blancher said. “It’s relatively cheaper than smoking, and it’s better for you and those around you. It doesn’t leave a nasty taste in your mouth. Other people can’t really smell [vaping], except for the flavor of the juice you are using.”
Blancher’s 10-year effort to quit smoking included changing brands, going to light cigarettes, switching to cigars, chewing nicotine gum and using a patch. With each method, he “would quit for a while, but as soon as I got around someone who was smoking, I wanted one.”
The Arizona Department of Health Services reports that more than 250 different e-cigarettes are sold in 70 percent of Arizona stores. Flagstaff retailers include Vapor Box and The Vapor Mill.
The Vapor Mill’s co-owner, Jay Park, says about half of the shop’s clients are trying to quit tobacco. Another 45 percent no longer smoke. The remaining five percent, Park among them, “have never smoked at all, but like the flavor of the vapor.” While most clients buy e-liquid at .3 or .6 percent nicotine, Park’s juice contains none.
Area prohibitions on e-cigarette use do not affect his operations, Park said. “There should be some regulations, but it should be up to the individual business owner whether to allow it or not. What I am finding is that most of the bars and restaurants don’t allow it anyway.
“It’s is a controversial thing. The more education we get about it, the less controversial it’s going to become. Also, I do think that people who use them have to be considerate of those who do not use them. I felt the same way about cigarettes. I don’t like being around cigarette smoke and I don’t like people blowing their vapor at me either.”
Blancher, a client of The Vapor Mill, said that he has read articles about carcinogen levels in vapor versus cigarettes. “It’s a lot lower, but it still has a lot of carcinogens in it. Less is better.”
Burley addressed observations about the product. “Many vendors and users claim that e-cigarettes emit only harmless water vapor. However, that is not the case. While not as polluting as a regular cigarette, the e-cigarettes do emit detectable levels of several significant carcinogens and toxins in the air. Propylene glycol, which is the main emission, is a known throat irritant.”
The American Lung Association identifies seven medications approved by the FDA for helping smokers quit tobacco. E-cigarettes are not among them.
“Switching to e-cigarettes and being exposed to e-cigarette emissions can sabotage the quitting process, as well as create air pollution for everyone to breathe,” Burley explained. “Although some people have been able to successfully switch… many have found that they become dual users. It’s important for those who quit smoking and other tobacco use to help their bodies heal from the damage. E-cigarette vapors still contain harmful chemicals that can damage lungs, other organs and the vascular system, which can reduce the healing process.”
Burley recommends the Arizona Smokers’ Helpline (ASHLine), which offers free FDA-approved nicotine replacement therapy and a quit coach at 800-556-6222 or www.ashline.org. FBN
By Sue Marceau
Flagstaff Business News